ASSESSMENT OF THE HEMODYNAMIC RESULT OF PTA WITH A DOPPLER GUIDE-WIRE- INITIAL EXPERIENCE

PURPOSE: To determine the usefulness of a Doppler guide wire for asses sing the hemodynamic results of balloon dilation of atherosclerotic ar terial obstruction. MATERIALS AND METHODS: A 0.018-inch 12-MHz Doppler guide wire was used to measure the maximum peak velocity and the time -averaged peak velocity (APV) proximal to, inside, and distal to lesio ns in 10 consecutively seen patients (six men, four women; mean age, 6 8 years +/- 11 [standard deviation]). Measurements were made before an d after percutaneous transluminal angioplasty (PTA). RESULTS: The prox imal-to-intrastenotic APV ratio was the best predictor of the grade of residual stenosis and correlated well with angiographic measurements (r = .8). Balloon dilation resulted in a significant increase in mean APV distal to the obstruction (12.5 cm/sec before versus 27.6 cm/sec a fter PTA; P < .05). The mean proximal-to-distal APV ratio also decreas ed significantly (3.7 before versus 1.0 after PTA; P < .005). CONCLUSI ON: The Doppler guide wire can be used for direct intravascular evalua tion of the result of balloon dilation in atherosclerotic obstructions .